Secondary Syphilis with Nodular Vasculitis Mimicking Behçet's Disease

Abstract

Although, erythema nodosum is a common skin manifestation associated with syphilis, nodular vasculitis is a rare feature. Here, we describe a case of a 22-year-old, human immunedeficiency virus negative, non-immunocompromised man who developed recurrent oral and scrotal ulcers with nodular lesions of the lower extremitie. Behçet's disease was initially suspected, however, his serologic test for syphilis was positive, and he was thus diagnosed with secondary syphilis, with a skin biopsy showing nodular vasculitis. The patient was treated with benzathine penicillin, and the skin lesions disappeared after treatment.

A Case of Latent Syphilis in Pregnancy Masked by Beçhet’s Disease

“…Clinical suspicion is highly required for the diagnosis since the manifestations of syphilis, "the great imitator," coincide with multiple diseases, including Behçet's disease. 7,8 There has been a yearly incidence of up to 6 million new cases of syphilis, implementing a high level of morbidity and mortality in the precious infants affected by the congenital disease. 9 Syphilis in pregnancy, if unmanaged, may cause serious complications for the fetus.…”

“…Upon further investigations, he was diagnosed with secondary syphilis and was accordingly treated, leading to a gradual improvement in his symptoms clinically. 8…”

Secondary syphilis mimicking sarcoidosis

“…It has been known itself to mimic other diseases and be difficult to diagnose. Common to this theme, syphilis has been misdiagnosed as a range of autoimmune diseases including Behcet's disease, 10 lichen planus, 11 and inflammatory bowel disease 12 …”

“…8,9 It has been known itself to mimic other diseases and be difficult to diagnose. Common to this theme, syphilis has been misdiagnosed as a range of autoimmune diseases including Behcet's disease, 10 lichen planus, 11 and inflammatory bowel disease. 12 US guidelines for syphilis diagnosis recommend use of a nonspecific test such as the rapid plasma reagin combined with a T pallidum-specific test for confirmation.…”

Unusual Presentation of Secondary Syphilis in Korea: 2010-2014 Review

“…46 These lesions should be distinguished from erythema nodosum, polyarteritis nodosa, tuberculosis, and a deep fungal infection. Jo et al 47 reported an interesting case of secondary syphilis with uncommon clinical features resembling Behçe's disease and histopathological features of nodular vasculitis.…”